How does ADHD medication work, anyway? Here are straightforward answers.
Will Meds Work for Me?
How can you know, or at what point do you know, that you are part of the 20 percent of people for whom meds don’t work?
The first-line stimulant medications for ADHD are among the most effective treatments in all of medicine. Unfortunately, as many as one in five people do not respond to the two standard stimulants, methylphenidate and amphetamine.
If you have tried both methylphenidate and amphetamine at adequate dosages, and have seen neither benefits nor side effects, it is possible that you are in the 3 percent of people who just do not absorb these medications orally. The formulation to try at this point is the transdermal delivery system, Daytrana,* also known as the patch.
When Do Side Effects Decrease?
Don’t some of the initial ADHD medication side effects smooth out after a short period? Is there an adjustment period? How long should I endure side effects before I change meds?
Most side effects of stimulant medications should resolve in three to five days (with the exception of appetite suppression). Side effects that the patient finds intolerable, or those that last longer than three to five days, warrant a call to your clinician.
When Do Meds Start Working?
How long does it take for an ADHD medication to have an effect? Is there an adjustment period, or do you know right away that it is a good option for managing symptoms?
There are two classes of medication for ADHD that treat symptoms: stimulants and non-stimulants.
The stimulant medications are effective as soon as they cross the blood-brain barrier, which takes 45 to 60 minutes.
The non-stimulant medications, like Strattera, Wellbutrin, Intuniv (guanfacine) and Kapvay (clonidine), are different. It often takes five to seven days after a dosage change to assess their benefits. As a result, it may take weeks to determine the optimal dose for these medications.
Losing Appetite
Does appetite suppression suggest that my son is taking too high a dose of stimulant?
Not necessarily. Appetite suppression is the only side effect of stimulants that is not necessarily dose-related. More predictive of appetite suppression is the child who is already thin and a picky eater. Although no one likes to take several medications, additional medication is often required for children who have appetite suppression lasting longer than two months, or who continue to lose body mass. Talk with your doctor.
ADHD and Mood Disorders
How do you treat ADHD in a person who has been diagnosed with a mood disorder?
Seventy percent of people with ADHD will have another major psychiatric condition at some time in their life. Psychological mood disorders and dysthymia are the most common conditions that coexist with ADHD. Most clinicians determine which condition is of most concern to the patient and proceed to treat that condition first.
Time for a Higher Dosage?
How do you know when it is time to go up in dosage? Will increasing my medication’s dosage help — or is trying a new medication the way to go?
It is important to remember that with both stimulant medications and non-stimulants there is a “therapeutic window.” Doses that are too low or too high are ineffective.
Start with the lowest dose of stimulant medication, increasing it periodically. Continue to increase the dose, as long as the target symptoms improve without the development of side effects.
*FDA is warning that permanent loss of skin color may occur with use of the Daytrana patch (methylphenidate transdermal system) for Attention Deficit Hyperactivity Disorder (ADHD). See the FDA Drug Safety Communication for more information.
Excerpted from “How Does ADHD Medication Work? Your First Questions Answered.” by William Dodson, MD, published in ADDitude Magazine. Read the full article for more extensive answers to the questions above and more questions and answers not included in the excerpt.
Source: ADDitude Magazine | How Does ADHD Medication Work? Your First Questions Answered, https://www.additudemag.com/how-does-adhd-medication-work-common-treatment-qs | Copyright © 1998 – 2023 WebMD LLC.
